Brain Disease and Creativity
Readers of this blog probably know I’m very interested in creativity. Recently, I came across a very interesting review paper on artistry in brain disease by Schott. Even though, many studies focus on the loss of various abilities as result of brain injury or disease, this review is focused on cases where brain disease resulted in enhanced artistic creativity in people with an interest in art or emergence of artistic creativity in art naive patients. Pictures created spontaneously by patient with brain disease sometimes present an excellent opportunity for studying that disease and revealing underlying mechanisms of cerebral dysfunction. It can also provide some useful information about creative processes in the healthy brain.
Dementia and stroke are very common. However, cases of patients who exhibit enhanced artistic output in these and other neurological disorders are rare or very rare. Miller et al. (2000) showed that enhanced artistry is probably more common but it is often under-reported, since new or preserved visual or musical ability was found in 17% of 69 patients with frontotemporal dementia.
In fact, frontotemporal dementia seems to be the brain disease more closely associated with increased creativity. Miller et al. (1996) were the first to report a patient with frontotemporal dementia that had developed new artistic creativity in the face of advancing dementia. A number of papers (Tanabe et al., 1996; Snowden et al., 1996), as well as Miller at al.’s seminal letter in the Lancet published in the same year brought more attention to the subject of preserved or increased artistic creativity in the presence of brain disease. Miller et al. (1996) described a 68-year-old male with a 12-year history of frontotemporal dementia,who, at the age of 56 years, started to paint having had no previous interest in art.
Patients with Alzheimer’s disease have also been reported to exhibit enhance artistic creativity. Professional painter, Danae Chambers, whose dementia started at around the age of 49 years (Fornazzari, 2005) is a striking example. Even though she was diagnosed with Alzheimer’s disease and her MRI scan revealed mild to moderate brain atrophy, there was no effect on her talent and creativity. However, it should be noted that typically during the progression of the disease stylistic changes leading to frank deterioration and eventual cessation of painting have been reported, especially in professional artists (see Crutch and Rossor, 2006).
In the case of autism there have been several cases of even very young autistics who could produce impressive works of art. A famous example is Stephen Wiltshire, who was able to draw astonishingly faithful architectural representations at the age of 7 years (Sacks, 1995).
According to Schott unexpected artistic creativity experienced by many patients has many features that suggest compulsive behaviour. Moreover, emergence of artistry after brain disease reflects innate rather than learned skills.
The brain correlates of emergent artistic creativity are rather obscure. It appears that dysfunction of the anterior temporal lobes is important if not crucial for the production of unexpectedly enhanced artistry, but the findings are often inconsistent. In some cases frontal lobe involvement is present too (Seeley et al., 2008). Thus creative drive is thought to increase not only with abnormalities of temporal lobe function and ‘release’ of frontal lobe-mediated creativity, but also by involvement of the dopaminergic mesolimbic system (Flaherty, 2005)
One might wonder; is this emergence of artistic talent observed in patients with various brain diseases really creativity?
De Souza et al. (2010) then concluded: ‘The emergence of artistic talent in patients with fvFTLD is explained by the release of involuntary behaviors, rather than by the development of creative thinking’, and also recommended avoiding consideration of ‘pseudo-creative production, or the emergence of “artistic talent”, as a mastered mental production’.
The author, however, disagrees and concludes:
…the notion of pseudo-creation and identification of ‘artistic talent’ create more difficulties than enlightenment; rather, they emphatically confirm the importance of patients’ pictures. The evidence for creativity surely lies in the creation itself rather than in perfusion patterns or psychological tests.
Schott, G. (2012). Pictures as a neurological tool: lessons from enhanced and emergent artistry in brain disease Brain, 135 (6), 1947-1963 DOI: 10.1093/brain/awr314